What is Diabetes Insipidus

For many people, the word “diabetes” often brings thoughts of either Type I or Type II diabetes. There are actually several forms of diabetes. Diabetes mellitus is the most disease with this name and is what most people think about. Diabetes insipidus is actually a hormonal disorder that directly affects the kidneys.

Some of the signs and symptoms of diabetes mellitus and diabetes insipidus are the same, but the most common symptom is an increased thirst that is almost insatiable. People with diabetes insipidus tend to always feel thirsty and will urinate much more than usual because of how many fluids they are pushing. It is an uncommon disorder, but one that requires treatment. Women who are pregnant can also develop a specific gestational form of this disease.

By knowing what causes this disease and how to respond to it, a proper diagnosis can be obtained. If you’re ready to discover what your body might be telling you when you’re excessively thirsty all of the time, then you are ready to discover if diabetes insipidus could be behind the bothersome symptoms that are being experienced right now.

What Causes Diabetes Insipidus?

The kidneys are the filtering system of the body. One of the things that they filter are the extra fluids that are within the body’s bloodstream. When there is too much water, then these extra fluids are stored in the bladder and become urine. When the kidneys are working properly, the amount of urine that is created will rise or fall based on the fluid levels that are placed within the body.

This means that if a person were to run a mile on a treadmill, then hormone levels rise in the body to prevent fluid loss. When the human body is at rest in a cool environment, then hormone levels will fall because there is less of a need to keep fluids. The amount of fluids that are consumed can even affect hormone levels.

When diabetes insipidus is present, this control is reduced because the hormones that tell the kidneys to remove the extra fluids malfunction in some way. Sometimes the kidneys don’t properly respond to the hormonal signals. At other times, the body changes the amount of the hormone that is produced. Called Vasopressin, it is made by the hypothalamus. From there, the pituitary gland will put it into the bloodstream.

Vasopressin acts as an anti-diuretic. It basically tells the kidneys that they need to stop bring fluids out of the bloodstream. If you’ve ever consumed a large amount of caffeine and then had to use the bathroom frequently for the next couple of hours because of the diuretic nature of the drug, then you’ve experienced just a glimpse of what life with diabetes insipidus can be like.

Sometimes the causes of diabetes insipidus are temporary. At other times that may be permanent. A person’s medical history and risk factors will typically lead doctors to a specific cause.

What Does ‘Insipidus’ Mean?

The ‘insipidus’ part of diabetes insipidus comes from the word ‘insipid’. It basically means that the urine of the person with this disease is dull, lacking flavor, or both. This is the reason why it is considered a type of diabetes.

In the past, doctors didn’t have the ability to test blood serum levels or conduct MRIs to see if there was an injury causing the disease. They had to rely on physical observations alone. This meant that doctors would actually taste or sample the urine that was collected from patients to determine their health.

When diabetes mellitus is present, which can be Type I or Type II diabetes, the urine of that patient has extra sugar levels in it that can be detected by taste. Diabetes insipidus falls on the other end of the spectrum, having little or no taste at all because it is very similar to water.

How Common Is Diabetes Insipidus?

Diabetes insipidus is quite rare within the general population of the world. Current estimates place the diagnosis rate at 1 case for every 25,000 people.

People who must undergo surgery of the pituitary gland for some reason have the greatest chances of developing diabetes insipidus. Up to 1 in 5 people may experience at least temporary symptoms of this disease after a successful operation.

A concussion or other head injury will also increase the diagnosis rate of diabetes insipidus when compared to the rest of the general population. For those who develop symptoms because of injury, only a small fraction of them will have persistent, ongoing problems for the rest of their life.

There Are 4 Different Types of Diabetes Insipidus

How the body reacts to the changes in Vasopressin will determine the form of diabetes insipidus that develops. At this point in time, researchers have discovered that there are 4 different types of this disease that will develop.

1. Central diabetes insipidus.
For individuals with this form of the disease, development tends to occur after a traumatic injury to either the pituitary gland or the hypothalamus. It may also be caused by surgery, the presence of a tumor, or the presence of another disease like meningitis. Sometimes simple inflammation around the pituitary gland can be enough to cause its formation. It can also be as a result of a genetic disorder.

2. Nephrogenic diabetes insipidus.
When there is a defect within the tubules of the kidney, then this form of the disease may develop. The tubules are where the kidneys are able to either absorb water or excrete it. When this defect is present, then the kidneys are unable to respond to the commands of the Vasopressin. This is typically caused by a genetic disorder, but chronic kidney diseases may also cause it. Certain prescription medications, such as demeclocycline or lithium may also cause disease development.

3. Gestational diabetes insipidus.
This effects only women and occurs during a pregnancy. Enzymes in the placenta will sometimes destroy the Vasopressin within the woman’s body and this causes the disease to form. Many women will have this disease resolve or lessen in severity after their child is born. The severity of this form of diabetes Insipidus often depends on the amount of enzyme that the placenta is producing or how effective the enzyme is at destroying the Vasopressin in the mother.

4. Dispogenic diabetes insipidus.
Sometimes referred to as Primary Polydipsia, this form of the disease occurs because of the drinking habits of the individual. Pushing fluids over a prolonged period of time will suppress Vasopressin and damage the kidneys. Over time, this prevents the kidneys from being able to concentrate the urine it creates. Mental illnesses or damage to the thirst regulating mechanisms within the brain may also cause this form of the disease.

Although most cases of diabetes insipidus can be linked to certain contributing factors, there are some people who develop the disease for no known medical reason. Each of these four types of diabetes insipidus may begin at any time, including in individuals who are historically healthy. This is why it is important to pay attention to the symptoms of this disease so that immediate medical help can be sought.

What Are the Symptoms of Diabetes Insipidus?

The most common symptoms and signs of diabetes insipidus being present are having an ongoing extreme thirst and an excessive amount of urine that is pale and diluted in nature. The amount of urine that is produced can help to determine how severe the disease progression happens to be. It can range from just 2 quarts of diluted urine per day to over 20 quarts per day if water consumption is out of control.

To compare with someone who does not have diabetes insipidus, about 1.5-2.5 quarts of urine are produced per day in healthy individuals.

This means someone may be producing the same amount of urine as they normally do. Paying attention to the color and consistency of the urine becomes important in the beginning stages of diabetes insipidus. Urine that is pale yellow or clear, accompanied by increased thirst without extra activities, can be an indication of the presence of this disease.

In children, the presence of diabetes insipidus may result in frequent bed-wetting. Children and adults may also find themselves getting up frequently throughout the night with an urgent need to urinate.

In newborns and infants, diabetes insipidus can be more difficult to notice. Parents will need to pay attention to these specific symptoms or outcomes.

1. Diapers that are frequently wet, but do not have a yellow color or tinge to them.
2. Crying or fussiness that is continual, unexplained, and inconsolable.
3. The presence of vomiting, diarrhea, or a fever that does not seem to get any better.
4. Skin that is dry and flaky with fingers and toes that are cool to the touch, even during the warm Summer months.
5. Delayed growth or weight loss.

Even if diabetes insipidus does not wind up being the final diagnosis that is given to a child or adult, medical help should be sought any time these symptoms appear and do not go away within 48-72 hours.

What Are the Risks of Developing Diabetes Insipidus?

Men are more likely to pass along the genetic causes of diabetes insipidus to their children. Women can also pass along the gene that causes the nephrogenic version of diabetes insipidus to their children, but much less frequently than men.

Women who become pregnant are automatically at a higher risk of developing the gestational version of diabetes insipidus.

Those who are at a higher risk of developing a mental illness or have been diagnosed with one already are at a higher risk of developing this disease. Injuries or accidents can happen at any time and cause the most common form of diabetes insipidus, so everyone has a certain, although very low, risk of disease development as well.

About 3 out of every 10 cases of diabetes insipidus has an unknown cause.

What Are the Complications of Diabetes Insipidus?

The most common problem that people who have diabetes insipidus face is dehydration. Except for the version where people will feel the need to consume fluids constantly, diabetes insipidus causes the body to not store enough water. Prolonged dehydration can cause several problems, including muscle weakness, low blood pressure, headaches, and a rapid heartbeat.

Electrolyte imbalances are another common complication of diabetes insipidus. Electrolytes are what the minerals in the blood are called. Sodium, iron, and potassium are just a few examples of electrolytes. When these grow out of balance, then irritability, fatigue, and unexplained muscle pains may occur.

How To Prepare For a Doctor Appointment

The thought of being diagnosed with diabetes insipidus can be frightening for many people. Most people will first meet with their family doctor, but some physicians may immediately send a referral to an endocrinologist instead so that an immediate treatment plan from a specialist can be created.

You may be asked to restrict certain activities before reporting for the doctor’s appointment. You may be asked to stop drinking water for up to 12 hours and perform other activities in advance. Follow all orders. Do not stop drinking water unless your doctor tells you to do so before the appointment.

If you suspect diabetes insipidus, then begin a journal that tracks the signs and symptoms that you have been experiencing. Note days, times, and the severity of the symptoms that are being experienced. This will give a doctor progression information about the disease that may be useful for diagnostic purposes.

If you are referred to a specialist immediately: Make sure to note all of your relevant medical information and key points of your medical history. You will want to have a complete list of all medications that you are taking. Include any all-natural supplements and OTC medications as they may interact with prescription medications.

The doctor will want to know about a history of head injuries and if there was any recent trauma. Requesting a medical record transfer to the specialist if the doctor is outside your health network can help to create a more accurate initial consultation.

If you have any questions about diabetes insipidus that you’d like to ask, take time to write them down before the appointment. Bring someone along to make sure that those questions get asked and any information the doctor provides is properly absorbed since a potential diagnosis like this can cause high levels of stress and anxiety.

What To Do While Waiting For a Doctor’s Appointment

Most doctors and specialists will make time to see a patient experiencing the symptoms of diabetes insipidus right away. There may be a few days of waiting, however, so it is important to eliminate the possibility of dehydration and electrolyte imbalance as much as possible.

Drink fluids until thirst is satisfied as often as necessary. Limit exercise activities and exposure to hot temperatures whenever possible to prevent fluid loss.

What To Expect During a Diabetes Insipidus Exam

An appointment with a doctor about diabetes insipidus will typically start with a check of basic vitals. From there, the doctor will ask a series of questions to determine the extent of the symptoms that are being experienced. Here is a sampling of some common questions that are asked during the interview portion of the appointment.

  • When were these symptoms first noticed?
  • How much more are you urinating now than before you became concerned?
  • How much water are you drinking every day right now?
  • Do you have to wake up at night to use the bathroom?
  • Have you taken medication in the past that are not on your current list?
  • Do you have a history of concussions or other head injuries?

For women who are experiencing the symptoms of diabetes insipidus, a doctor will want to exclude the possibility of a pregnancy. Even if one isn’t expected because of birth control or contraceptive methods being practiced, a simple pregnancy test will often be order to definitively exclude the possibility of gestational diabetes insipidus.

How Is Diabetes Insipidus Diagnosed?

If you present with the symptoms of diabetes insipidus to your doctor and this is the suspected problem, then there are urine and blood tests that can help to determine if this condition is present. These tests include testing sodium levels, blood plasma concentrations, and urine concentration levels.

It is also common for a doctor to order what is called a fluid deprivation test. This test is usually medically supervised and the individual being tested will be prevented from consuming any fluids for several hours. After the initial urine and blood tests are run to establish a baseline, another series of tests will be run after the fluid deprivation test. These tests may occur on an hourly basis until the fluid deprivation test has been completed.

Doctors may also choose to inject desmopressin, which is an artificial version of Vasopressin, to track how it reacts within the body. This typically occurs when diabetes insipidus has been diagnosed, but the specific type of the disease is not yet known. About 60 minutes after the injection has been given, urine tests to determine overall concentration levels will be conducted. If the concentration levels of the urine are 50% higher than the baseline, then the central version of this disease will typically be diagnosed. Under 50% levels typically indicate a genetic disorder.

If there is a suspicion of a physical injury being the cause of the condition, then an MRI may be ordered to check on the condition of the pituitary gland or the hypothalamus.

Is Diabetes Insipidus Serious?

Diabetes insipidus is not going to lead to kidney failure. The presence of this disease is not an indication that someone will need to start dialysis at some point in the future. The kidneys are actually still operational when this disease is present. They filter out the contaminants that are in the blood. During the process of this filtering action, they just take too much water out of the body. This means the goal of any treatment is going to be to replace those fluids and limit the extreme thirst that some people have when diabetes insipidus is present.

This means someone who suspects that they may have diabetes insipidus must have fluids around at all times to prevent dehydration from setting in. Athletics, working out, and other physical activities are still safe, but there must be more fluid replacement available for these individuals when compared to the rest of the general population. The presence of heat will be the largest contributing factor to the presence of dehydration, even if there are no activities that are being performed.

Doctors may also prescribe specific medications, dietary changes, and other lifestyle habit changes to promote better health when diabetes insipidus is diagnosed. A full treatment plan must be followed at all times for the signs and symptoms of diabetes insipidus to fade into remission.

Nephrogenic diabetes insipidus tends to be the most serious of the four different types of this disease. This is because the kidneys are failing to read the Vasopressin that is being produced by the body. Sometimes this resistance is caused by a medication and may resolve if that medication is removed from the body. Unique treatment plans must be developed because of the individualistic nature.

Diabetes Insipidus Does Not Have To Control a Life

Diabetes insipidus should be taken seriously, but once diagnosed, it can be effectively managed. Take steps to make sure fluids are available on a consistent basis, seek a specific treatment plan from an endocrinologist, and listen to what the body has to say. That is the best way to overcome the signs and symptoms of diabetes insipidus.

Use this guide to form the questions you’ll want to ask your doctor about this condition. In doing so, you will give yourself peace of mind, no matter what the outcome may be.